I have a gut condition known as SIBO – small intestinal bacterial overgrowth. I’ve had it for years, without knowing it. Well, I knew there was something going on in my gut, I just didn’t know what it was. And, as of today, I’m following the SIBO elemental diet, to get rid of this once and for all!
I tried various different approaches to figure out what was happening. My doctor gave me a colonoscopy, which was delightful, but didn’t find any reason for my grumbling, growling, bloated belly. I knew I was intolerant to some foods, gluten being a main contributor, so I went strictly gluten free. Given that I have a family history of coeliac disease, and Parkinson’s disease, I’m happy to stay off gluten permanently, as I know what a troublesome little protein it is. But, while I felt better off gluten, even that didn’t solve my problem.
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Last year, after pondering for about the whole of the previous year, I started on the GAPS diet. This is a gut healing diet, and does wonders for many people with leaky gut, a variety of other gut conditions, and mental health disorders. Kids with behavioural issues do amazingly well on GAPS. It’s a staged diet, meaning you start off quite restricted, to give your gut a rest, then you progressively add in more foods as you go along. It’s purpose is primarily to heal and seal the gut lining. It’s a totally grain free diet. It’s the most restricting diet I’ve ever done (until now).
It wasn’t so bad, the GAPS diet. I came to love many of the foods that are the mainstays of GAPS, especially the broths and the soups. In fact, I ate soup, with a full clove of raw garlic, a couple of raw egg yolks, half a mashed avocado, and a big spoon full of duck fat, for breakfast every day for months. Delicious!
About 10 days into the GAPS diet, I woke up one morning. I mean, I really woke up. I woke up and realised that I was awake… really awake. I had all this amazing energy, my head was clear, my body was itching to get up and do something. It was incredible. I may not have felt this way since I was a teenager (but I really can’t remember!). My stress levels plummeted overnight and I felt great. Amazingly, this boundless energy persisted, even after I went off the ‘proper’ GAPS diet.
The one thing that didn’t change, though, was this grumbly, growly, bloated belly. What I did work out, as I was adding foods back into my GAPS diet program, was that I was intolerant to some odd foods. Cauliflower, for one. Apples. Mango. Garlic. Onion. Sigh.
I can’t recall how I first came across the term SIBO, but when I did, boy did it open my eyes. All these foods that I had figured out that I was intolerant to, were foods that are high FODMAP foods. FODMAP stands for ‘fermentable oligosaccharide, disaccharide, monosaccharide, and polyols’. These are a particular type of carbohydrate that are fermented by your gut bacteria. When you have SIBO, your gut bacteria are literally in the wrong place. They are not necessarily bad bacteria, but they have relocated themselves from where they are meant to be, in your large intestine or colon, to your small intestine. So, when you eat foods that contain FODMAPs, you are essentially feeding these bacteria before you are feeding yourself. And when they are happy little well fed bacteria, they produce a lot of gas, which makes you bloated.
So, I read about SIBO, and I realised that this was likely the final piece of the puzzle. Many, if not most, people who get SIBO can pinpoint when it started, because often it starts following a particular event. A bout of gastroenteritis is the most common triggering event. Low stomach acid is another reason for SIBO to develop. Surgery is another, and for me, this was the trigger. When you have surgery, the anaesthetic slows or stops your digestion. When this happens, it stops the natural muscular ‘wave’ that occurs through your digestive tract between meals, which is designed to both move your food through your system, but also to clean, for example, to clean out any bacteria that you might have picked up from your food. This is called the migrating motor complex. What can also happen, is that your normal gut bacteria get active and move themselves backwards through your system, ending with them taking up residence in your small intestine. To top it off, the pain relieving medication you take after surgery compounds the problem because it also slows this ‘wave’. I know, quite clearly, that my gut started having problems within two weeks of having surgery.
Anyway, I did the test to diagnose SIBO, which is a breath test, and it was strongly positive. I consulted with a practitioner, because even though I was a newly qualified nutritionist, it’s hard to treat yourself, and I wanted some guidance. SIBO treatment can be complex, with a very specific low FODMAP diet, some herbal antibiotics to kill off the bacteria, and some supplements to keep this muscular ‘wave’ working well. The treatment program can take 3-6 months. I was all set to go, and started the treatment program. Within two days, I was feeling so much different. On the third day, my family experienced a sudden, unexpected, major family event that changed our lives. My treatment went out the window while we dealt with that situation.
And here I am, more than a year later, with much more experience, and plenty of motivation to solve this SIBO problem once and for all!
There is another way to treat SIBO, and that’s with what’s known as an ‘elemental diet’. This is literally a liquid diet, made up of the basic building blocks of what your food is broken down to in your body – pure protein, a small amount of honey as a carbohydrate, some fat (coconut oil or olive oil) and some salt. That’s it.
I’ve treated quite a number of clients with SIBO now, in my nutrition practice, and many have come through the treatment program successfully. For myself, while I knew I could cope with a restricted diet after spending almost a full year on the GAPS diet, I am impatient. I could spend 3-6 months on a restricted diet with a supplement regime, or I could spend 14 days (or so) on an elemental diet and be done with it. I think you can guess what I chose.
Much research shows that 14 days on this elemental diet will eradicate SIBO. After that, you just need to take some precautions in order to prevent a relapse. This was a really attractive option for me. The downside was that I’d read many, many times, that this elemental diet, which is a homemade recipe that you just prepare yourself, tasted pretty damned awful. Like, really, really, really bad. I have to admit, I was worried.
About a week ago, my supplies arrived. I made up a very small batch (this stuff is too expensive to waste!), and tried it out. With great relief, I discovered it was far from the worst thing I’ve tasted. I can do this, I told myself!
It turns out to be slightly longer than 14 days on the diet, because on the 15th day, you do another breath test, and then need to wait a day or two for the results before you know if you’re all clear. If not, you continue for a few more days. So, I’m counting on maybe 17 days, if all is clear in the test. That’s 50 doses, 50 times I have to drink this mixture. But who’s counting?
So, today was D-day. Day #1. 50 doses and counting. I made up the mixture for breakfast in my trusty Thermomix – not that you need a Thermomix, you just need a blender of some sort to mix.
I mixed the amino acids (the protein), the honey, salt and coconut oil first. It made a paste, and I wondered whether I could just eat the paste off a spoon, rather than adding water and drinking it. The first mouthful was ok, but there was a fair bit of it, and I didn’t think I could tolerate getting through it spoon by spoon. I added some water, and found that when I blended it, the coconut oil separated and solidified. Doh. You don’t want to heat amino acids too much, not at all if you can help it, because there is a risk that you alter their structure, which alters their function. This is where my Thermomix really came in handy, because I could heat the mixture ever so slightly, knowing it wouldn’t heat too much. I just heated it for about 45 seconds, just enough to melt the coconut oil back through the mixture. Mmmm mmmm, deliciousness coming up!
I tried drinking it through a straw, but it wasn’t so good. I thought about just downing the whole glass full in one go, but knew that I couldn’t chase it with anything to take away the taste. So, I kind of drank it fast-ish, a few mouthfuls at a time, and got through it in 3 goes. It’s not that bad. I’ve drank much worse! But, ask me in a few days, and I’m sure I’ll be complaining.
One down, 49 to go.
Half an hour later, I was doubled over with stomach cramps from hell. Ouch.
I thought I might throw up, but that would be the worst thing because then I’ve wasted a whole dose of the amino acid powder, and, I’d have to drink it again! Thank goodness the cramps only lasted about 10 minutes or so. Lesson here: probably best to drink it slower. I do remember reading ‘some people prefer to sip the mixture throughout the day’. I guess this could be why. Lunch will be a slower affair.
I’m curious to see how this all plays out. Using an elemental diet is a great option for my clients who prefer to get the treatment out of the way quickly, and if I have personal experience in doing this, I can advise them on what I’ve learnt from my time using this approach.
Lunch time came and went… and I was not hungry at all. In fact, it became evening and I still wasn’t hungry, but I knew I had to eat. I couldn’t have forced myself to eat (drink) at lunchtime even if I wanted to, but by dinner I knew I must. I found some macadamia oil in the pantry so thought I’d try that in place of the coconut oil to evaluate the taste.
Turns out the very thing I thought made it ok tasting (the honey that makes it taste sweet) is the thing I’m already not liking. It’s so sickly sweet. Tomorrow I’ll adjust the recipe and try some dextrose instead, which is less sweet. I drank it slower tonight, to avoid the stomach cramps. Turned out it took me about 2 hours to get through it because of the sweetness!
Anyway… day 1… done!